What question did this study set out to answer?

To investigate the effects of Angelica sinensis polysaccharide on endometriosis via the Keap1/Nrf2/HO-1 pathway.

March 14, 2026Journal of Zhejiang University (Medical Sciences)0 citationsOpen Access

Angelica sinensis polysaccharide ameliorates endometriosis in rats by restoring autophagic homeostasis through inhibition of Keap1/Nrf2/HO-1-mediated oxidative stress

Key Points

To investigate the effects of Angelica sinensis polysaccharide on endometriosis via the Keap1/Nrf2/HO-1 pathway.
Rats were divided into groups and treated with Angelica sinensis polysaccharide for 4 weeks.
Ectopic endometrial tissue mass and volume were measured.
Levels of oxidative stress markers and autophagy indicators were assessed.
Pathological changes in uterine/ectopic tissue were evaluated using histological techniques.
Western blot and immunofluorescence were used to measure protein expression.
Endometriosis symptoms in model control rats worsened with increased oxidative stress markers.
Treatment with Angelica sinensis polysaccharide reduced ectopic endometrial tissue mass and volume.
Oxidative stress markers such as ROS, MDA, and p62 decreased following treatment.
Autophagy markers like LC3-II/LC3-I protein levels and autophagosome numbers increased post-treatment.

Abstract

ObjectiveTo investigate whether Angelica sinensis polysaccharide ameliorates endometriosis by suppressing oxidative stress and thereby restoring autophagy via the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway.MethodsRats were randomly divided into six groups (n=12 per group): normal control group, model control group, low-dose Angelica sinensis polysaccharide group, high-dose Angelica sinensis polysaccharide group, gestrinone group, and high-dose Angelica sinensis polysaccharide+Keap1 activator (recombinant Keap1 protein, rKeap1) group. Except for the normal control group, EMS models were established in all the other groups. After successful modeling, treatments were administered once a day for 4 weeks. The mass and volume of ectopic endometrial tissue were measured. Pathological changes, levels of reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD) in uterine/ectopic endometrial tissue were assessed. The number of autophagosomes in uterine/ectopic endometrial tissue was observed using transmission electron microscopy. The relative fluorescence intensity of microtubule-associated protein light chain 3 (LC3) was detected by immunofluorescence staining. Western blot was used to measure the protein expression of LC3-II/LC3-I, p62, Keap1, nuclear Nrf2 and HO-1 in uterine/ectopic endometrial tissue.ResultsCompared with uterine endometrial tissue in normal control group, the model control group exhibited increased glandular proliferation in ectopic endometrial tissue, prominent vacuolization of glandular cells, and a large number of inflammatory cell infiltration. The levels of ROS, MDA, p62 and Keap1 were significantly increased (PPPPConclusionAngelica sinensis polysaccharide may improve EMS by inhibiting theactivation of the Nrf2/HO-1 pathway by Keap1, reducing oxidative stress in rats and restoring autophagy homeostasis.

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